Alprazolam: Review of PBS utilisation following rescheduling to Schedule 8
Page last updated: 4 March 2016
Drug utilisation sub-committee (DUSC)
To assess the utilisation of alprazolam supplied through the Pharmaceutical Benefits
Scheme (PBS) following its rescheduling from Schedule 4 (S4) to Schedule 8 (S8) in
the Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP) on
1 February 2014.
Pharmaceutical Benefits Scheme (PBS) Listing
Alprazolam was first listed on the PBS on 1 December 1993.
Alprazolam has an Authority Required PBS listing for the treatment of panic disorder where other treatments have failed or are inappropriate.
Four data sources were used:
- DUSC database;
- Department of Human Services (DHS) pharmacy claim database;
- DHS Authority approvals database; and
- data on supply of all brands of items listed on the PBS, provided to the Pharmaceutical Benefits Division of the Australian Department of Health to administer the price disclosure policy.
The utilisation of alprazolam supplied through the PBS declined by about one third immediately after rescheduling to S8 and has continued to decline since.
Changes in alprazolam use in the first 12 months after rescheduling compared with the previous 12 month period include:
- a 35% reduction in the number of prescriptions dispensed;
- a 30 % reduction in the total number of patients dispensed at least one prescription; and
- a 35 % reduction in the number of new patients starting alprazolam.
These trends were unique to alprazolam and not observed in other benzodiazepines.
No significant change in the amount of alprazolam dispensed per prescription was observed.
In the months surrounding the rescheduling of alprazolam, about double the number of patients switched from alprazolam to diazepam or oxazepam compared to usual levels.
Private prescriptions comprise about a quarter of the total community prescriptions of alprazolam. Based on limited data, the private prescription market appears to have declined to a similar extent as the PBS market, however further sources of data would be required to confirm this trend.